Mechanism of Gynecomastia in Mixed Germ Cell Tumors

• Increased HCG (produced by syncytiotrophobastic giant cells)

• Increased Aromatase Activity

• Incresed Porduction of Estrogen (Leydig and Sertoli Cells)

• Decreased GNRH

• Decreased LH

• Decreased p-450c17 Activity

• Deceased Testosterone Production